挤压伤和挤压综合征的发病及救治

挤压综合征是挤压伤后严重的并发症,主要原因是肌肉丰富的部位受到挤压及缺血性损害后,解除挤压及恢复血供后,大量有害因子入血,出现以急性肾功能衰竭为主的症候群,死亡率较高,救治困难。挤压伤及挤压综合征提倡早期诊断及救治,救治措施主要包括现场急救、抗休克、预防感染、保护肾脏功能、维持水电解质平衡、人工肾脏替代,及营养支持等几方面措施。

Occurrence and treatment of crush injury and crush syndome

Crush syndrome develops due to muscle crush injury often found in patients extricated from pro- longed compression after disasters. It leads to rhabdomyolysis, kidney failure and hypovolemie shock. It is a chal- lenge for surgeons because it is regularly associated with potentially fatal complications. Treating the acute kidney injury caused by crush syndrome in survivals of Ihe earthquake has been a big challenge to the nephrologists. The comprehensive treatment includes field first aid, compensation of fluid and countershock, infection prevention, ne- phroprotection, maintenance of water-electrolyte balance, hemodialysis （ HD ） , fasciotomy and systematic alimentotherapy.